Sentara Health aligns its provider and payer sides, with the patient at the center

Sentara Health aligns its provider and payer sides, with the patient at the center

Sentara Health, a health system serving Virginia and Northeastern North Carolina, has undergone a transformation to what it calls One Sentara – a strategic aligning of its provider and payer organizations to create a seamless and affordable experience for its customers.

THE PROBLEM

Prior to the One Sentara realignment, the care delivery side and health plan side functioned as virtually two independent businesses. That often led to patient and member abrasion with duplication of services such as care management.

It also contributed to a perception by patients and members that the health system did not “know” them.

“The One Sentara transformation allows us to create shared services that provide a high-quality, consumer-centric and consistent experience,” said Tim Skeen, executive vice president and CIO at Sentara Health. “It’s about making healthcare interaction more simple, seamless, personal and affordable, from end to end.”

PROPOSAL

It’s important to understand that the One Sentara strategic alignment has at its center the consumers, Skeen explained.

“They are the focus of all that we do,” he said. “As an integrated healthcare delivery network, we knew we needed to more closely align, and streamline, our delivery of care along with our healthcare coverage processes.

“To this end, Sentara is migrating from fragmented patient interactions to a holistic view of our patients and members,” he continued. “Patients are not acute or ambulatory, they’re just people who need care. Often the language of healthcare is confusing at a time when people need clarity the most.”

To solve this problem, Sentara is implementing a clinical access center where it has centralized scheduling, answering calls, and aligning a patient to the right clinical resource and referrals.

“Coupled with the clinical access center, we are implementing an omnichannel experience and preference management, which will allow patients to receive the information they need from the channel they prefer,” Skeen noted. “We are seeing extremely positive results in post-encounter surveys with our members and patients as a result of the changes we are implementing.

“Patients are no longer on hold or left voicemail, they are speaking to people and receiving the digital feedback interactions they expect,” he continued. “Additionally, as we implement these improvements, we are uncovering numerous opportunities for optimization and key processes across our delivery system.”

MEETING THE CHALLENGE

The One Sentara transformation creates a need for a consistent platform for care management while enabling value-based contract performance for the integrated health system, Skeen said.

“It is important to remember we are never done when it comes to enhancing the customer experience,” he explained. “As needs change, so will technology, and we need to keep our fingers on the pulse to ensure we are effective.

“Two key strategic initiatives we have launched on our enterprise data platform include the Consumer Data Hub and the Enterprise Data Fabric,” he continued. “The Consumer Data Hub will provide a secure 360-degree view of the consumer – encompassing members, patients or prospects – to enrich our understanding and interaction with them.”

Similarly, the Enterprise Data Fabric will unify the diverse data sources, offering immediate access and enabling advanced analytics powered by AI and machine learning.

“These efforts are designed to enhance data management and governance, ensuring smooth integration and access across the organization and with partners; and drive data-driven decision-making and highly personalized consumer experiences, setting a new benchmark in service excellence,” Skeen said.

Key focuses include:

  • Mastering consumer records, creating detailed profiles for better engagement

  • Mastering provider records, ensuring healthcare professionals’ data is meticulously managed

The objective is to transcend operational efficiency, fostering more insightful decision-making and a tailored approach to capture consumer interaction.

“Additionally, we are investing in a real-time Customer Experience Dashboard, providing feedback loops to zero-in on issues and connect operational leaders to pain points,” Skeen explained. “Our team is focused on finding the pain points, delivering on changes and providing a continuous feedback loop for improvements.

“As part of Sentara’s enterprise-wide focus on consumer experience, we have re-platformed our entire customer experience platform with the latest technology,” he added. “This includes digitizing all pre-arrival paperwork, registration and questionnaires to make the initial interaction process more seamless and streamlined.”

A few key examples of other changes include implementing new large language model platforms to route patient inquiries to the proper queues and decrease provider burnout. Staff are renovating the entire access digital experience for larger flexibility with appointments and rescheduling.

“We also are redesigning our communications to support queueing patient requests against the proper resources,” he noted. “For example, pharmacy refills go to a specialized team and rescheduling is handled in our new Clinical Access Center – freeing clinicians to focus on patient care.

“Using external data to complement our clinical data to achieve a fuller picture of our patients and members is vital to our mission,” he continued. “We are incorporating social determinants of health data in a variety of our initiatives both in the community and within the system.”

Sentara Health uses publicly available data like census data and applies it to geocoded analysis to examine the characteristics of its patients, members and communities. It also incorporates data from third-party aggregators that use broader SDOH information to add specific predictors of risk across a variety of conditions like diabetes and congestive heart failure, as well as specific events like ED visits and hospitalizations.

RESULTS

“2023 was an exciting year for all of us here at Sentara, and we are equally excited about what 2024 holds for us,” Skeen said. “We released our new strategic plan, ‘One Sentara: Our Way Forward,’ with the objective to create a simple, seamless, personal and more affordable experience for those we serve.

“A key component of this effort was the establishment of a new department, the Transformation Office,” he noted. “This office serves as a hub for driving change, fostering innovation and ensuring efforts are aligned with strategic priorities. We believe this office will be instrumental in helping us create a health system that is even more consumer-centered and industry-leading.”

Areas where Sentara Health has already seen success, according to Skeen, include:

  • Structure. Hard-wired capabilities across the organization have resulted in increased transparency and accountability with the implementation of uniform tools and processes for all projects. This includes creating infrastructures that purposefully bring together the patient and member experiences.

  • Engagement. Leaders from across the organization have come together to ideate, plan and implement initiatives including launching a systemwide ideation tool. Also, launching new cultural attributes that align with the new strategic plan.

  • Investing. A foundational capability to serve patients and members. From these foundations the health system is enabling new models of care and more seamless interactions, and reducing administrative anxiety in areas like bill pay, lab scheduling, reducing paperwork and establishing an engagement center.

ADVICE FOR OTHERS

“Engage your team members broadly and deeply to identify opportunities to achieve the strategy,” Skeen advised. “The strategy cannot be executed in a silo with a small set of leaders given the critical dependency on organizational change management and culture change.

“Create a prioritized portfolio of initiatives ranked by business and financial value,” he added. “Instill a sense of urgency to execute on the highest valued initiatives focused on early wins while taking a multi-year approach to achieve comprehensive transformation.”

Follow Bill’s HIT coverage on LinkedIn: Bill Siwicki
Email him: bsiwicki@himss.org
Healthcare IT News is a HIMSS Media publication.

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